Objective To investigate the changes in platele aciveation in terms of platelet fibrinogen receptor expression(PAC-1),P-selectin(CD62P),Thromboxane B2(TXB2),Endothlin(ET-1),Fibrinogen(FIB)in patients undergoing elective Sirolimus-eluting stents implantation and dual anti-platelet therapy.Methods Forty in-hospital patients with stable coronary heart disease(CHD)were enrolled in this study.Dural anti-platelet therapy with aspirin and clopidogrel were prescribed at least three days before operation to achieve sufficient inhibition of platelet activation in all patients.Peripheral artery blood samples were collected before the procedures,immediately and at 6 hours and 24 hours after the procedure,levels of PAC-1,CD62P,TXB2,ET-1 and FIB were measured.All patients were followed up for 6-12 months.Results Expression of PAC-1 and CD62P was increased significantly after stenting compared with pre-stenting and the peak appeared at 6 hours post-operation(PAC-1,P=0.001,CD62P,P=0.007,PAC1+CD62P,P=0.003).TXB2 was also increased and the peak appeared at 24 hours post operation(P=0.021).Plasma levels of ET-1 and FIB showed no difference before and after stenting.After CAG,expression of PAC-1 and CD62P,levels of TXB2,ET-1 and FIB had no significant differences compared with pre-CAG.No MACE happened in all patients.Conclusion The routine dual anti-platelet therapy cannot suppress platelet activation after elective coronary Sirolimus-eluting stents implantation.Plasma FIB and ET-1 levels were not affected by stents implantation.

The necessity to carry out student-oriented teaching of Medical information retrieval and use course in medical postgraduate was analyzed according to its theory followed by an elaboration on its module setting, course management methods, course examination forms and teachers.

Objective To investigate the clinical application of pancreatic head resection with the second portion duodenectomy (PHRSPD). MethodsThe clinical data of 4 PHRSPD cases were analyzed retrospectively. ResultsThere were 3 benign and 1 low-grade malignant periampullary tumors. The mean surgical time was 417 min, mean blood transfusion was 533 ml, mean hospital stay was 28.6 days. Delayed gastric emptying was encounted in one case. There was no hospital morality or major surgical complications. All cases were alive in the follow-up ranging from 6 to 36 months. There was no newly developed diabetes mellitus or severe gastroenteral symptoms. No reccurrence was found in the case with low-grade malignant duodenal tumor after 26 months. ConclusionsPHRSPD is an efficient way to treat benign and low-grade periampullary neoplasm and accompanying massive bleeding episodes.

ObjectiveTo explore the development and mechanism of hepatic cell apoptosis, and the effect of anti-apoptosis apoptosis of Se in the liver in obstructive jaundice rats. Methods(GPx) activity and (ROS) level were measured by biochemical methods,terminal-deoxynucleotidyl medicated nick end labeling (TUNEL)in different groups at different time points, and analysed by multivariate regression. Results Apoptosis cells appeared on day 3 after common bile duct(CBD) ligation ,significantly increased on day 7,reached the peak level on day 11, and began to decrease on day 14. The longer the time of obstructive jaundice in rats, the higher the level of ROS and apotosis index(AI), while the level of GPx decreased progressively. AI reached the peak 11-day after CBD ligation. Less hepatic apoptosis appeared after the rats treated with Se at every time point (P

ObjectiveTo study the cardioprotective effects of ischemic post-conditioning on elderly patients with ST-elevation acute myocardial infarction (STEM1).MethodsConsecutive 215 patients with STEMI undergoing emergency percutaneous coronary intervention(PCI) were randomly assignedto receive ischemicpost-conditioningorconventional PCItreatment.The ischemic postconditioning (n=38) were conducted by 3 episodes of 30-second occlusion followed by 30-second reperfusion, while the control group (n= 46) was without any intervention after PCI.Reperfusion arrhythmias, corrected TIMI frame count (cTFC) and TIMI myocardial perfusion grade (TMPG)were compared between the two groups, respectively.Results The incidence of reperfusion arrythmias was less frequent in ischemic postconditioning group (21.1％ ,8/38) than in control group (45.7％ ,21/46) after PCI (x2 = 5.571, P＜0.05). The TIMI grade 3 flow was similar between two groups [(94.7％(36/38) vs. 82.6％( 38/46), x2= 2.919, P＞0.05], the cTFC levels (23.6±3.7vs. 26.1 ±5.9) and TMPG 3 perfusion [ 89.5％ (34/38) vs.69.6％ (32/46)] were significantly different (t= 5.434, P＜0.05; x2 = 4.899, P＜0.05, respectively) between two groups.ConclusionsIschemic postconditioning may reduce myocardial reperfusion injury in elderly patients with STEMI undergoing emergent PCI.

Objective To study vascular anatomy between the pancreatic head and duodenum,providing anatomy basis for performing surgery of pancreatic head,duodenum and distal common bile duct in surgical practice. Methods Anatomy study was performed in 30 formaldehyde fixed and 10 fresh bodies in reference to blood supply to duodenum,the distal common bile and Vater ampulla. Results The anterior and posterior pancreaticoduodenal arterial arcade gives off branches to descending and horizontal portion of the duodenum. The posterior superior pancreaticoduodenal artery goes to distal common bile duct. The papilla artery arising from the posterior superior pancreaticoduodenal artery goes to Vater ampulla. Conclusions The pancreaticoduodenal anterior and posterior arterial arcades are main arteries that give off branches to the descending and horizontal portion of the duodenum,distal common bile duct and the Vater ampulla,hence should be carefully protected in duodenum-preserving resection of the pancreatic head.

Objective To explore the degeneration of motor end plates (MEP) by observing the expression of calcitonin gene-relative peptide (CGRP) and acetylcholine esterase (AChE) in the MEP after different types of spinal cord injury. Methods 60 adult female Wistar rats were randomly assigned to 3 groups: sham group, completely transection group and contusion group. The content of AChE in the MEP was detected with Karnovsky-Roots staining and the expression of CGRP was then determined with immunohistochemistry. Results The content of both AChE and CGRP significantly decreased after either type of spinal cord injury. However, their activity gradually recovered to the normal level in the contusion group, but not in the transection group. Moreover, the changes of CGRP occurred earlier than those of AChE. Conclusion The motor end plate degenerates differently after different kinds of spinal cord injury in adult rat, CGRP and AChE are related to the degeneration of MEP.

To investigate the safety, feasibility and effectiveness of transrectal high-intensity focused ultrasound (HIFU) in the ablation of canine prostate, 20 dogs were divided randomly into 5 groups. Sixteen canine prostates were treated with the third-generation transrectal HIFU device (Sonablate-500). Transrectal ultrasound images of the prostate and prostatic urethra were observed preoperatively and postoperatively. Serial study was performed 30 min, 30 days, 60 days and 180 days after the therapy. The rectum, periprostatic tissues, and prostate were excised en bloc and the tissues were fixed for gross and histological analysis. Our results showed that the average maximal diameter of prostatic urethra was 0.59+/-0.11 cm before the operation and 2.57+/-0.98 cm 60 days after the operation. The volume of prostate was 6.5+/-3.12 cm(3) before the treatment while the volume was 4.13+/-0.23 cm(3) 60 days after the treatment and the differences were statistically significant (P<0.05). Histologically, there was a clear demarcation between the necrotic area of the treated tissues and the unaffected surrounding tissues. All the necrotic tissues in the targeted zone broke off and the prostatic urethra became cavitary 60 days later. The more frequent complications were urinary retention and frequency and hematuria. No rectal injury occurred during the treatment. It is concluded that the third-generation transrectal HIFU is capable of destroying prostatic tissue, substantially increasing the width of the prostatic urethra without causing injury to the adjacent tissues. The risk of postoperative complications associated with HIFU was low. HIFU may become a safe, effective and minimally invasive alternative for the treatment of prostatic diseases.

Objective To observe the effect of the chitosan tube combined with basic fibroblast growth factor(bFGF) on inducing nerve axon regeneration of rats with peripherial nerve injury.MethodsA novel chitosan tube combined with bFGF was developed and used to suture the 10 milimeter long right sciatic nerve gap of 10 rats,single injury group(10 rats) were the control with sciatic nerve injury alone,and other 10 rats were assigned to sham group.Immunohistochemistry and electrophysiology study had been done to observe the effect of repairing.Results3 months after operations,the sciatic nerve gap were repaired by the regeneration nerve in the experiment group.And there was no evident inflammation in the defects.ConclusionThe chitosan tube combined with bFGF can induce the sciatic nerve to regenerate.

ObjectiveTo explore the possibility of repairing sciatic nerve gap of rats with artifical nerve graft.MethodsA novel artifical nerve guide was developed and used to suture the 15 milimeter long right sciatic nerve gap of 10 rats, other 7 rats were the control with the right sciatic nerve gap alone.2 and 4 monthes after operation, immunohistochemistry, Osmium staining, Bodian staining,motor end plate staining,WGA-HRP stain tracing have been done to observe the effect of repairing.Results2 months after operations, the sciatic nerve gap were repaired by the regeneration nerve.There was not evident inflammation in the defects.ConclusionsThe artifical nerve graft can induce the nerve to regenerate.